肺灌注/通气显像与螺旋CT肺动脉造影诊断肺栓塞的对比研究

目的评价肺灌注/通气显像与螺旋CT肺动脉造影诊断肺栓塞各自的敏感性。方法以肺动脉造影为金标准,并按不同栓塞部位分为叶及段肺动脉、亚段肺动脉两组;按肺动脉狭窄程度分为严重狭窄(超过50%)和轻度狭窄(少于50%)两组。对40例疑肺栓塞患者先后行肺核素显像和螺旋CT肺动脉造影检查,根据分组分别比较两种方法的敏感性。结果①肺动脉造影共确定叶及段肺动脉栓塞102支。其中,肺灌注/通气显像显示86处叶及段性肺灌注/通气不匹配,敏感性为84.3%;螺旋CT肺动脉造影示98支,敏感性为96.1%;②肺动脉造影共确定140支亚段肺动脉栓塞,其中肺灌注/通气显示120处,敏感性为85.7%;螺旋CT肺动脉造影显示115支,敏感性为82.1%;③肺动脉狭窄程度>50%时,通气/灌注显示109处,螺旋CT肺动脉造影显示97支;肺动脉狭窄程度<50%时,通气/灌注显示91处,螺旋CT肺动脉造影显示121支。结论对叶及段肺动脉栓塞,两种方法敏感性基本相同;对亚段肺动脉栓塞,肺灌注/通气显像略高;肺血管轻度栓塞时,螺旋CT肺动脉造影略高。

Comparison study on ventilation-perfusion imaging and spiral CT angiography in the diagnosis of pulmonary embolism

Objective:To compare the sensitivity rate of the ventilation-perf usion scintigraphy (V/P) and CT angiography (CTA) in the diagnosis of pulmonary embolism (PE).Methods:Use of pulmonary ar teriography as standard, 40 patients with sus pected PE were underwent both ventilation-perfusion scintigraphy (V/P) and CT angiography (CTA). Results:For 102 lo bar or segment PE, the V/P showed 86, the s ensitivity rate was 84.3%,CTA showed 98, the sensitivity rate was 96.1%; while f or the 140 subsegment PE,V/P showed 120, the sensitivity rate was 85.7%, CTA sho wed 115, the sensitivity rate was 82.1%. Conclusion: For lobar or segment PE, he sensitivity rate is same. For subsegmenta l PE, the V/P is more sensitive than CTA; For slight embolism, the CTA is more sensitive th an V/Q.